课程题目(tímù)：腹腔镜输尿管切开取石术内容提要：腹腔镜输尿管切开取石术适应证和手术相关问题考核题目：腹腔镜输尿管切开取石术的适应证，下列哪种说法不正确：1.因结石平片影淡，造成ESWL失败2.因BPH，造成URS失败3.大的、高位输尿管上段结石4.输尿管下段结石治疗(zhìliáo)的首选方法5.作为开放手术的替代治疗对于直径大于1.5cm、致密坚硬且导致输尿管完全梗阻的结石，以下哪个部位是腹腔镜输尿管切开取石的适应证：1.上段2.中段3.下段4.全部都是1第一页，共八十四页。腹腔镜输尿管切开取石术Laparoscopicureterolithotomy(LUL，LU)复旦大学附属中山(zhōnɡshān)医院泌尿外科孙立安2015.8.112第二页，共八十四页。输尿管腹腔(fùqiāng)段的解剖31Duodenum2Ureter3Psoas4Inferiormesentericartery5Testicular/ovarianarteryandvein6Genitofemoralnerve;femoralandgenitalbranches7Sigmoidarteries8Superiorrectalartery第三页，共八十四页。输尿管盆腔(pénqiāng)段的解剖（男性）41Ureter2Commoniliacartery3Superiorhypogastricplexus4Externaliliacartery5Internaliliacartery6Testiculararteryandvein7Sigmoidarteriesandveins8Superiorrectalarteryandvein9Hypogastricnerve10Middlerectalartery11Genitofemoralnerve1213Inferiorhypogastric(pelvic)plexus14Inferiorvesicalartery,veinandvesicalplexus15Superiorvesicalarteryandvein第四页，共八十四页。5输尿管盆腔(pénqiāng)段的解剖（女性）1Ureter2Commoniliacartery3Superiorhypogastricplexus4Externaliliacartery5Internaliliacartery6Ovarianrarteryandvein7Sigmoidarteriesandveins8Superiorrectalarteryandvein9Hypogastricnerve10Middlerectalartery11Genitofemoralnerve1213Inferiorhypogastric(pelvic)plexus14Inferiorvesicalartery,veinandvesicalplexus15Superiorvesicalarteryandvein第五页，共八十四页。Gerota'sfascia第六页，共八十四页。7输尿管的血供第七页，共八十四页。8输尿管的血供1Mucosa2Musclecoat3Adventitia4Mesoureter5Supplyingarteryandvein6Adventitialvascularplexus7Perforatingarteries8Mucosalvascularplexus第八页，共八十四页。9输尿管的分段(fēnduàn)第九页，共八十四页。输尿管结石(jiéshí)的治疗方法1.ESWL2.URS3.PCNL(L4以上)4.开放手术5.腹腔镜手术（LUL）6.药物治疗与等待(děngdài)观≤察（5mm）10第十页，共八十四页...
